Chawda S J, Watura R, Adams H, Smith P M
Department of Radiology, Llandough Hospital, Penarth, Vale of Glamorgan, UK.
Dis Esophagus. 1998 Jul;11(3):181-7; discussion 187-8. doi: 10.1093/dote/11.3.181.
We evaluated the relationship between radionuclide esophageal transit studies and barium swallow appearances in a group of patients following forceful balloon dilatation for the treatment of achalasia of the cardia. Paired erect radionuclide esophageal transit studies and erect barium swallows of a group of patients who had undergone pneumatic balloon dilatation for the treatment of achalasia were analyzed. Indices derived from the radionuclide transit study were the percentage of maximum activity remaining in the esophagus 30 s after swallowing a dilute volume of tracer (A30 s) and the percentage of retained activity remaining at 100 s after washout with a bolus of water (A100 s). Indices derived from the barium swallow were a subjective grading of the degree of esophageal dilatation on a 4-point scale and a similar grading of the maximum distensibility of the gastroesophageal channel. Twenty five pairs of radionuclide and barium studies in 18 patients were analyzed. There was statistically significant correlation between the amount of retained activity on the radionuclide studies and degree of esophageal dilatation on the barium studies (r = 0.69 for A30 s, r = 0.56 for A100 s, P = < 0.01). There was no correlation between the amount of retained activity on the radionuclide studies and the degree of distension of the gastroesophageal channel on barium studies. The relationship between the radionuclide esophageal transit curve and barium appearances of the esophagus following pneumatic balloon dilatation for the treatment of achalasia is complex. The transit study provides unreliable information about the distensibility of the gastroesophageal channel and should not be relied upon in isolation for assessment of the efficacy of treatment.
我们评估了一组因贲门失弛缓症接受强力球囊扩张治疗的患者中放射性核素食管通过研究与吞钡造影表现之间的关系。分析了一组因贲门失弛缓症接受气囊扩张治疗的患者的配对直立放射性核素食管通过研究和直立吞钡造影。放射性核素通过研究得出的指标是咽下少量示踪剂后30秒时食管中剩余最大活性的百分比（A30秒）以及用水团冲洗后100秒时剩余的滞留活性百分比（A100秒）。吞钡造影得出的指标是食管扩张程度的主观4级评分以及胃食管通道最大扩张性的类似评分。对18名患者的25对放射性核素和钡剂研究进行了分析。放射性核素研究中的滞留活性量与钡剂研究中的食管扩张程度之间存在统计学显著相关性（A30秒时r = 0.69，A100秒时r = 0.56，P = < 0.01）。放射性核素研究中的滞留活性量与钡剂研究中胃食管通道的扩张程度之间无相关性。对于治疗贲门失弛缓症的气囊扩张后，放射性核素食管通过曲线与食管钡剂表现之间的关系很复杂。通过研究提供的关于胃食管通道扩张性的信息不可靠，不应单独依靠它来评估治疗效果。
